BHRT Treatment Protocol
At this first consultation if there are no contra-indications to BHRT, Dr. Berry educates the patient about BHRT and encourages questions to be asked. All clients receive appropriate counselling. Dr. Berry prescribes trans-dermal creams, lozenges and capsules which are all bio-identical and all formulated individually depending on the patient's symptoms. Dr. Berry works also with the patient's preferences. A London Compounding pharmacy formulates the individualized scripts. The patient is then reviewed at 3 monthly intervals. A little "tweaking" of the hormone formulation is sometimes required depending on symptoms. Our goal is hormone optimization with a focus on physical and emotional wellness in addition to disease prevention. All consultation e-mails during the first month are free. Dr. Berry also offers Skype follow up consultations for clients who find it difficult to attend a clinic or for overseas clients. However, it is a legal requirement that patients are seen at least yearly in a clinical setting. It is particularly important to note that BHRT does not provide contraceptive cover. Adequete contraception must be used until one year after the menopause. All patients are advised to perform a monthly self examination of breasts.
BHRT Treatment involves, first the completion of a confidential detailed medical questionnaire on line. A blood kit for a hormonal profile is sent to the patient. If the patient is still menstruating, Dr. Berry prefers that the blood sample be drawn on day 21 of the cycle (Day 1 is the first day of menstruation). Blood can be drawn at their GP practice if they are willing to do it, or if not the patient will be notified of a location where blood can be drawn. The first consultation will be for 60 minutes at which time the blood results will be discussed along with a treatment plan if there are no contra-indications to BHRT. Patients are asked to bring a urine sample to this first consultation. Dr. Berry also asks that the patient bring copies of recent blood results and reports from their GP to this first consultation if available e.g. blood results such as a fasting lipid profile, full blood count, liver and kidney function; reports such as mammogram, pap smear, DEXA scan and ultrasound of pelvis. A negative mammogram is a pre-requisite to treatment as is a negative breast examination performed at the first consultation. Any suspicious vaginal bleeding is a contra-indication to BHRT and would need investigating asap, initially with an ultrasound of pelvis and/or referral to a Gynecologist. A patient with a history of breast cancer constitutes a special category. This type of case will be managed on a case by case basis in conjunction with the Breast Surgeon and Oncologist. In order for a patient with a history of breast cancer to receive BHRT, Dr. Berry must have the consent of the Breast Surgeon and Oncologist.